Provider Demographics
NPI:1467042184
Name:HOME CARE MO INC.
Entity Type:Organization
Organization Name:HOME CARE MO INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:DIMITRI
Authorized Official - Middle Name:
Authorized Official - Last Name:MISHIEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-954-4535
Mailing Address - Street 1:100 S 4TH ST FL 5
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63102-1800
Mailing Address - Country:US
Mailing Address - Phone:314-666-8010
Mailing Address - Fax:929-447-1101
Practice Address - Street 1:100 S 4TH ST FL 5
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63102-1800
Practice Address - Country:US
Practice Address - Phone:314-666-8010
Practice Address - Fax:929-447-1101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-26
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health